Primary care networks build on the core of current primary care services and enable the greater provision of proactive, personalised, coordinated, and more integrated health and social care.
Primary care networks are based on GP-registered lists, typically serving natural communities of around 30,000 to 50,000.
Core PCN Funding
The Core PCN Funding for the period 1 April 2024 to 31 March 2025 is calculated as £2.916 per patient, with £2.218 being multiplied by the PCN registered list size as at 1 January 2024 and £0.698 multiplied by PCN adjusted population as at 1 January 2024. This combines the funding that was previously labelled as Core PCN Funding, Clinical Director Payment and PCN Leadership and Management Payment.
Enhanced Access Payment
The Enhanced Access payment for the period 1 April 2024 to 31 March 2025 is calculated as £7.674 multiplied by the PCN’s Adjusted Population at 1 January 2024.
Care Home Premium
The payment is calculated on the basis of £120 per bed for the period 1 April 2024 to 31 March 2025.
The number of beds will be based on Care Quality Commission (CQC) data on beds within services that are registered as care home services with nursing (CHN) and care home services without nursing (CHS) in England.
PCSE will make monthly payments based on care home bed numbers provided by commissioners. Payments are made at a rate of £10 per bed per month for the period 1 April 2024 to 31 March 2025 based on the number of relevant beds in the PCN’s Aligned Care Homes. The commissioner must ensure that the number of beds on which payment is based is updated on a monthly basis in line with the CQC Care Directory.
Payment will only be made where the commissioner is satisfied that the PCN or its Core Network Practices have comprehensively coded care home residents using appropriate clinical codes as follows:
160734000 – Lives in a nursing home;
394923006 – Lives in a residential home; and
248171000000108 – Lives in care home (finding)
Capacity and Access Support Payment
The Capacity and Access Support Payment for the period 1 April 2024 to 31 March 2025 is calculated as £3.248 multiplied by the PCN’s Adjusted Population at 1 January 2024.
A PCN has four key functions:
a) co-ordinate, organise and deploy shared resources to support and improve resilience and care delivery46 at both PCN and practice level;
b) improve health outcomes for its patients through effective population health management and reducing health inequalities;
c) target resource and efforts in the most effective way to meet patient need, which includes delivering proactive care; and
d) collaborate with non-GP providers to provide better care, as part of an integrated neighbourhood team.
1. Supporting and improving resilience and care deliveryA PCN must work with, and support, its Core Network Practices to improve the quality and effectiveness of its delivery of the Network Contract DES, whether components are delivered at PCN or practice level. To achieve this, the PCN must continuously work to improve patient experience and the care that patients receive. This involves ensuring effective allocation of funding and Additional Roles Reimbursement Scheme capacity across the PCN as well as supporting the effective configuration of practice capacity. It also involves supporting the application of peer-review and continuous improvement techniques across Core Network Practices.
2. Improving health outcomes and reducing health inequalities
A PCN must seek to improve health outcomes for its population using a data-driven approach and population health management techniques in line with guidance and the CORE20PLUS5 approach. The approach must include, but is not limited to, the following activities:
a) use of insightful analytics, alongside improved data recording and use (including ethnicity), to target care and improve outcomes in populations groups where there is greatest opportunity;
b) working with partners, including community pharmacy, to proactively identify and manage CVD risk, hypertension and raised lipids in line with nationally agreed guidance and pathways;
c) reviewing cancer referral practice in collaboration with partners and working to improve early diagnosis; and
d) working with partners to improve screening uptake, inclusive of breast, bowel and cervical cancer.
A PCN should actively seek to reduce health inequalities across its Core Network Practices in line with guidance and the CORE20PLUS5 approach. To address health inequalities, a PCN should work in partnership within local communities to deliver effective outreach and target care to address health inequalities that are amendable to primary care intervention.
3. Targeting resource and efforts
A PCN must contribute to the delivery of multi-disciplinary proactive care for complex patients at greatest risk of deterioration and hospital admission, by risk stratifying patients and offering care in accordance with the guidance. This must be done as part of INTs, with the aim of reducing avoidable exacerbations of ill health, improving quality of care and patient experience, and reducing unnecessary hospital admission.
Other key requirements of a PCN are to:
a) detail the measures a PCN will take to improve medicines optimisation and implement those measures, including ensuring medicines management and use of Structured Medication Reviews for high-risk cohorts, as specified in the Guidance. This should include medicines optimisation strategies for reducing polypharmacy, minimising risk of prescribing harm, reducing over-prescribing and managing the risk of dependency on prescription drugs;
b) provide access to a social prescribing service to those who may benefit, so as to help meet the practical, social and emotional needs that can otherwise affect health and wellbeing; and
c) deliver an Enhanced Health in Care Homes service in accordance with the framework and guidance including
I. agreement with the commissioner for which care homes the PCN is responsible;
II. identifying a lead GP (or other senior clinician) with responsibility for implementation of the EHCH framework for the agreed care homes, and to provide continuity of medical care;
III. co-ordinating an MDT meeting and associated actions, including the lead GP or clinician and care home staff;
IV. delivering a weekly care home round; and
V. ensuring accurate coding of care
4. Collaboration with non-GP providers to provide better care
A PCN must work with other PCNs, local community services providers, mental health providers, community pharmacy providers and other relevant health and social care delivery partners in the best interests of patient care. This includes developing and fostering strong relationships with other clinical leaders and commissioners to successfully manage the health and care needs of the populations they serve.
A PCN must provide enhanced access between the hours of 6.30pm and 8pm Mondays to Fridays and between 9am and 5pm on Saturdays.
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PRN01035_iii_Network-contract-DES_Part-A-Clinical-and-support-services-Section-8
PRN01035_iv-Network-Contract-DES-Part-B-guidance-non-clinical-April-2024
PRN01035_v-PCN-adjusted-populations-spreadsheet-2024-25
PRN01035-ii-PCN-DES-Contract-specification-2024-25-PCN-requirements-and-entitlements-April-2024
PRN00157-contract-specification-2023-24-pcn-requirements-and-entitlements
Understanding primary care networks – 2019
Network Contract DES specification – 2020/21
Network Contract DES Guidance 2020-21
Enhanced health in care homes – CPA guide
Framework for enhanced health in care homes
Early cancer diagnosis guidance